Policy Implications for Implementing Evidence-Based Practices

Abstract

The authors describe the policy and administrative-practice implications of implementing evidence-based services, particularly in public-sector settings. They review the observations of the contributors to the evidence-based practices series published throughout 2001 in Psychiatric Services. Quality and accountability have become the watchwords of health and mental health services; evidence-based practices are a means to both ends. If the objective of accountable, high-quality services is to be achieved by implementing evidence-based practices, the right incentives must be put in place, and systemic barriers must be overcome. The authors use the framework from the U.S. Surgeon General's 1999 report on mental health to describe eight courses of action for addressing the gap between science and practice: continue to build the science base; overcome stigma; improve public awareness of effective treatments; ensure the supply of mental health services and providers; ensure delivery of state-of-the-art treatments; tailor treatment to age, sex, race, and culture; facilitate entry into treatment; and reduce financial barriers to treatment.

Understanding Community Mental Health Administrators' Perspectives on Dialectical Behavior Therapy Implementation

“…Experts have also discussed clinicians' need for a “learning period” in which they take fewer clients and have their work time offset to enable them to prepare for consumer sessions and observe other clinicians implementing treatment (5,11), all of which is difficult from an administrative standpoint because of lost productivity and revenue. Although precise numbers may be unavailable, rough estimates from treatment researchers regarding resources needed to implement a new intervention would allow administrators to make more informed choices and would permit administrators to better plan for implementing and sustaining the treatment.…”

“…Experts suggest that successful implementation of evidence-based treatment requires the commitment of consistent, long-term financial resources (4), sufficient personnel for training and implementation (5), and support of organizational leaders (6). Despite the integral role of mental health agency leaders in the implementation process, relatively few studies have examined their perspectives.…”

“…Studies that have examined the role of organization leaders have not conducted personal interviews (5). To enhance our understanding of mental health administrators' perspectives on opportunities and challenges in implementing an evidence-based treatment, we conducted semistructured interviews with administrators of community mental health agencies.…”

Implementation of Evidence-Based Practices for Treatment of Alcohol and Drug Disorders: The Role of the State Authority

“…15 The most prevalent examples are lack of a long-term vision, lack of agreement on desired outcomes, lack of penalties for non-evidenced-based practices, short-term horizons for policy planning, political mandates on competing public-sector priorities, resource limitations, and uncertainty associated with change and untoward events. 50 Phase 2 of this project will identify SSA-specific barriers to EBP implementation.…”

A Functional Guide to the Evidence-Based Practice Movement in the Substance Abuse Treatment Field

“…Scholars (Goldman et al, 2001;McGovern & Carroll, 2003;Miller & Carroll, 2006) note that stakeholders within the substance abuse treatment community grapple with several questions pertinent to EBPs: Why are purchasers of substance abuse treatment services demanding that substance abuse treatment providers adopt EBPs? What are appropriate evidentiary standards for EBPs?…”